The overall goal of this research proposal is to perform a demonstration and a critical appraisal of a new information resource, the Clinical Data Repository (CDR) in a pilot site, the University of Virginia Heart Center. The CDR was developed by University of Virginia Health System (UVAHS) staff [Scully, Pates, Desper, Connors, Harrell, Pieper, Hannan, and Reynolds, in pres] and results from merging five legacy databases: 1) three years of inpatient billing and administrative data from approximately 75,000 hospital admissions; 2) a cardiac surgery clinical database; 3) physician billing data, inpatient and outpatient; 4) the statewide Virginia Health Information (VHI) database of hospital performance indicators; and 5) the University HealthSystems Consortium (UHC) patient-level database of discharge abstract information. This research project will test and evaluate the capabilities and the limitations of the CDR in answering specific questions related to clinical effectiveness; assess the perceptions of clinicians and managers of the value of the information provided for improving clinical or management processes; and make recommendations for improving the CDR as an information resource for improving patient care and health services management. The long term goal is to create a comprehensive database for both clinical research and administrative reporting.